Proposed law would mandate minimum direct care nurse hours

A bill that would establish around-the-clock registered nurse staffing hours at Medicare and Medicaid nursing homes and skilled nursing facilities was introduced by an Illinois congresswoman last week.

Under the bill, introduced by Rep. Jan Schakowsky (D-IL), long-term care facilities must use services of at least one registered nurse to provide “assessment, surveillance and direct care to residents 24 hours a day, 7 days a week.”

The bill defined “surveillance” as the “ongoing acquisition, interpretation and synthesis of residents' data for clinical decision making.”

Nursing facilities have been caring for increasingly complex residents but are not required to have an RN on duty for more than eight hours a day, Schakowsky noted in a prepared statement released Friday.

"The need for at least one RN could not be more urgent," Schakowsky said.

If passed, the bill would amend Titles XVIII and XIX under the Social Security Act and would be effective after the first day of the first calendar quarter one year after the date of enactment.

Research on the association between nursing home staffing levels and quality care has produced mixed results.

A 2013 state-by-state analysis from the advocacy group Families for Better Care found that states with highly staffed nursing homes ranked far better than those with lower staffing hours; however, a 20-case analysis conducted by researchers in New York City and the Netherlands found “no consistent relationship” between nursing home staffing and quality of care.

Schakowsky introduced the bill on July 31. She also serves as the co-chairwoman of the Democratic Seniors Task Force, which focuses on addressing the needs of older Americans.

About 60,000 elderly or disabled Medicaid recipients in Louisiana are being told they should expect to lose their benefits in July, and advocates say more than a quarter of them could be forced out of the long-term care facilities they call home.